In hospitals and nursing homes difficulties have been encountered where patients are restrained in bed and not under direct observation of a nurse or attendant. Such restraint is advisable, particularly during the night, for the patient's protection. Conventionally, a harness or arrangement of straps, such as a Posey belt, is used to permit normal movement of the patient's limbs but prevent leaving the bed; the Posey belt, for example, overlies the trunk of the patient and extends, in figure eight fashion, around the mattress with the two ends of the belt tied together beneath the mattress. Often, a patient so restrained awakes during the night and is confused and disoriented. His initial, determined reaction is to frantically break away from the restraint and get out of bed, the act being attempted, often, with surprising strength because of the patient's confused state of mind. The conventional nurse call-button, accessible at bedside, is ignored by the patient. Whether or not the attempt to leave the bed is successful, because the patient is disoriented and temporarily unaware of the height of the bed, the possibly slippery floor, adjacent night stand or the like, fractures or other injuries to the patient often result.
Patrolling the halls and rooms are intervals is a partial solution to the problem. However, the incidents may occur just after the patient has been observed as asleep and quiet. Tighter or more complete restraint of the patient can cause damaging pressure and circulation restriction and, in general, tighter restraint seems only to trigger a more violent release attempt by the patient during these incidents.